112
12 Societal Effects of a Nuclear Attack
That being said, a terrorist attack’s effects on the larger (national) society is likely
to resemble our experiences in Japan more than to Cold War planning because it
would most likely involve a small number of relatively low-yield nuclear weapons,
leaving the majority of the nation intact and prepared to render assistance to the
survivors.
12.1 Public Health
The effects of a nuclear detonation on the health of individuals was discussed in
Chap. 11, here we will examine the public health effects.
12.1.1 Radiation Injury
The most obvious concern following a nuclear attack is the number of people
expected to suffer from radiation illness and injury. Flynn and Goans [2] discuss
four primary categories of patients, grouped by their radiation exposure and the
expected symptoms. The following paragraphs are summarized from their paper.
• Group I patients are those with an exposure of less than about 2 Gy. These patients
might or might not require hospitalization, depending on their symptoms and their
lymphocyte count. In the short term, they should be kept under close observation
with periodic complete blood cell counts (with differential) and can be managed as
outpatients unless their physical injuries (e.g. thermal burns, lacerations) require
attention. No patients in this group are likely to die of their radiation exposure
alone, although the majority of those with exposures greater than 1 Gy are likely
to fall ill with radiation sickness.
• Group II patients are those with exposures between about 2–5 Gy. These patients
will require hospitalization and, without proper medical care, some of these
patients may die of their radiation exposure. Radiation can kill lymphocytes and
will impair the body’s ability to produce new lymphocytes for several weeks
or months, as a result reverse isolation will help protect against succumbing to
opportunistic infections until the immune system can become reestablished. Early
growth factor (cytokine) therapy and prophylaxes (viral and fungal), and antibiotics should be considered, along with selective gut decontamination using oral
antibiotics.
• Group III patients are those who have received an exposure of between 5 and
10 Gy and all of these patients should be hospitalized with reverse isolation
and early growth factor therapy. These patients, too, should receive selective gut
decontamination as well as viral prophylaxis and anti-fungal therapy; antibiotics
should be administered early in anticipation of severe neutropenia. Flynn and
Goans also recommend that both Group II and III patients receive assistance from
12 Societal Effects of a Nuclear Attack
That being said, a terrorist attack’s effects on the larger (national) society is likely
to resemble our experiences in Japan more than to Cold War planning because it
would most likely involve a small number of relatively low-yield nuclear weapons,
leaving the majority of the nation intact and prepared to render assistance to the
survivors.
12.1 Public Health
The effects of a nuclear detonation on the health of individuals was discussed in
Chap. 11, here we will examine the public health effects.
12.1.1 Radiation Injury
The most obvious concern following a nuclear attack is the number of people
expected to suffer from radiation illness and injury. Flynn and Goans [2] discuss
four primary categories of patients, grouped by their radiation exposure and the
expected symptoms. The following paragraphs are summarized from their paper.
• Group I patients are those with an exposure of less than about 2 Gy. These patients
might or might not require hospitalization, depending on their symptoms and their
lymphocyte count. In the short term, they should be kept under close observation
with periodic complete blood cell counts (with differential) and can be managed as
outpatients unless their physical injuries (e.g. thermal burns, lacerations) require
attention. No patients in this group are likely to die of their radiation exposure
alone, although the majority of those with exposures greater than 1 Gy are likely
to fall ill with radiation sickness.
• Group II patients are those with exposures between about 2–5 Gy. These patients
will require hospitalization and, without proper medical care, some of these
patients may die of their radiation exposure. Radiation can kill lymphocytes and
will impair the body’s ability to produce new lymphocytes for several weeks
or months, as a result reverse isolation will help protect against succumbing to
opportunistic infections until the immune system can become reestablished. Early
growth factor (cytokine) therapy and prophylaxes (viral and fungal), and antibiotics should be considered, along with selective gut decontamination using oral
antibiotics.
• Group III patients are those who have received an exposure of between 5 and
10 Gy and all of these patients should be hospitalized with reverse isolation
and early growth factor therapy. These patients, too, should receive selective gut
decontamination as well as viral prophylaxis and anti-fungal therapy; antibiotics
should be administered early in anticipation of severe neutropenia. Flynn and
Goans also recommend that both Group II and III patients receive assistance from